1417288549 NPI number — QUALITY OF LIFE HEARING SOLUTIONS, INC

Table of content: (NPI 1417288549)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417288549 NPI number — QUALITY OF LIFE HEARING SOLUTIONS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUALITY OF LIFE HEARING SOLUTIONS, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SEARS HEARING AID CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417288549
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
581 STATE ROUTE 17M
Provider Second Line Business Mailing Address:
SUITE 8
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-238-5514
Provider Business Mailing Address Fax Number:
845-238-5516

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SEARS HEARING AID CENTER
Provider Second Line Business Practice Location Address:
5200 KINGS PLAZA
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-252-4244
Provider Business Practice Location Address Fax Number:
718-252-4251
Provider Enumeration Date:
01/29/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BOCHTERLE
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
845-238-5514

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)